Canada's first annual report on the state of public health has just been published Chief Public Health Officer of CanadaDr. David Butler-Jones.

The report summarises the key determinants of health that underlies the health and wellbeing of Canadians: income, employment,environment, housing, education, nutrition, access to medicalservices and individual lifestyles.

It also outlines key Canadian and international initiativesaimed at reducing inequalities. Interestingly HIA is mentioned in relation to Quebec’s Public Health Act (Article 54).

The report described this as:

"A unique approach to public health in the province of Quebec has other provinces and, indeed, other countries, taking notice. By requiring other government departments to consult with theMinister of Health and Social Services in regard to decisions or actions that could impact publichealth – a broader, more comprehensive and inclusive approach to public health strategies andinterventions has been taken.420 The consulting component of this ‘whole of government’ approach came into law with the adoption of Article 54 in Quebec’s Public Health Act in 2001. It states that new measures provided for in an Act or regulation in all provincial ministries be assessed to determine significant impacts of proposed actions on the health of populations. A health impact assessment (HIA) process is currently used to carry out these determinations, an approach that is fairly new to Canada outside of Quebec but more common in some European countries. At the national level, Canada’s National Collaborating Centre for Healthy Public Policy is currently studying HIA in relation to Article 54 and public policy, and will disseminate its findings to the public health community."